ASSOCIATION BETWEEN AUTISTIC SPECTRUM DISORDER AND PRECOCIOUS PUBERTY: A NATIONWIDE COHORT STUDY

Abstract Background Limited knowledge is available about the association between autistic spectrum disorder (ASD) and precocious puberty. Aims & Objectives Our study examined the association between the two medical conditions, and the effect modification by sex and neuropsychiatric comorbidities in a nationwide population. Method To compare the risk of precocious puberty between ASD and non-ASD cases, we conducted Cox regression analysis with ASD as exposure and time-to-precocious puberty as outcomes adjusting for sex, attention-deficit/hyperactivity disorder (ADHD), tics disorder, obsessive– compulsive disorder (OCD), anxiety disorder, intellectual disability, and epilepsy. We performed a moderation analysis to examine the potential moderating effects by sex or comorbidities. Results Patients with ASD have a higher risk of precocious puberty compared with non-ASD individuals, with an adjusted hazard ratio (aHR) of 1.80 (95% CI: 1.61-2.01). For the effect modification, sex, specifically female, moderated the association between ASD and precocious puberty, with relative excess risk due to interaction (RERI) 7.35 (95% CI 4.90-9.80). No significant effect modification was found for any of the comorbidities within the scope of additive effect modification. Discussion & Conclusion We found that patients with ASD had a higher risk of precocious puberty, regardless of sex or comorbid neuropsychiatric disorders. Girls with ASD are at particularly high risk to develop precocious puberty.